Last fall when I visited Canada, I met a Toronto doctor named Gary Bloch who has developed a poverty tool for medical practitioners. The tool assesses what patients might need other than prescriptions for the newest drugs. Bloch’s idea was to zoom in on the social determinants of health — food, housing, transportation — all poverty markers linked to bad health and poor health outcomes.
The tool, a four-page brochure, notes that poverty accounts for 24 per cent of a person’s years of life lost in Canada and offers three steps for doctors to address poverty. The first step is to screen every patient by asking them, “Do you ever have difficulty making ends meet at the end of the month?” The next two steps urge clinicians to factor poverty into clinical decisions like other risk factors and to ask questions about income support by age/family status, such as whether seniors have applied for supplemental income benefits they may be entitled to.
“We’ve created an advocacy or interventional initiative aimed at changing the conversation about poverty and how doctors think about poverty as a health issue,” Bloch explained. “It’s one of those cultural shift things.”
The first blog post I wrote about Bloch and his “diagnosing poverty” tool received more than 3,000 hits on the Prepared Patient blog. Clearly, his message resonated in the U.S. and Canada. I wanted to circle back to Bloch and see whether a cultural shift in Canada was really taking place. Indeed it is. I was wowed by the acceptance of an intervention that seems so simple and could maybe lead to better health. “It’s been a wildfire effect,” Bloch told me.
via Meet the Canadian Doctor Who Prescribes Income to Treat Poverty | Trudy Lieberman.
